Number of Hospital Days Covered. Provided the conditions, including the requirements below, are met and continue to be met, as determined by CareFirst, hospital benefits for inpatient hospital services will be provided as follows:
A. Hospitalization for Rehabilitation Benefits are provided for an admission or transfer to a CareFirst approved facility for rehabilitation. Benefits provided during any admission will not exceed any applicable benefit limitation. The limit, if any, on hospitalization for rehabilitation applies to any portion of an admission that:
1. Is required primarily for Physical Therapy or other rehabilitative care; and
2. Would not be Medically Necessary based solely on the Member's need for inpatient acute care services other than for rehabilitation.
B. Inpatient Coverage Following a Mastectomy Coverage will be provided for a minimum hospital stay of not less than:
1. Forty-eight (48) hours following a radical or modified radical Mastectomy; and
2. Twenty-four (24) hours following a partial Mastectomy with lymph node dissection. In consultation with the Member’s attending physician, the Member may elect to stay less than the minimum prescribed above when appropriate.
C. Hysterectomies Coverage will be provided for vaginal hysterectomies and abdominal hysterectomies. Coverage includes a minimum stay in the hospital of: SAMPLE
1. Not less than twenty-three (23) hours for a laparoscopy-assisted vaginal hysterectomy; and
2. Not less than forty-eight (48) hours for a vaginal hysterectomy. In consultation with the Member’s attending physician, the Member may elect to stay less than the minimum prescribed above when appropriate.
D. Childbirth Coverage will be provided for a minimum hospital stay of not less than:
1. Forty-eight (48) hours for both the mother and newborn following a routine vaginal delivery;
2. Ninety-six (96) hours for both the mother and newborn following a routine cesarean section. Prior authorization is not required for maternity admissions. Whenever a mother is required to remain hospitalized after childbirth for medical reasons and the mother requests that the newborn remain in the hospital, coverage includes additional hospitalization for the newborn for up to four (4) days. If the delivery occurs in the hospital, the length of stay begins at the time of the delivery. If the delivery occurs outside of the hospital, the length of stay begins upon admission to the hospital. The Member and the attending physician may agree to an early discharge. Non-routin...
Number of Hospital Days Covered. Provided the conditions, including the requirements below, are met and continue to be met, as determined by CareFirst, hospital benefits for inpatient hospital services will be provided as follows:
Number of Hospital Days Covered. Provided the conditions, including the requirements in Section 2.3, are met and continue to be met, as determined by CareFirst BlueChoice, hospital benefits for Inpatient Hospital Services will be provided as follows:
A. Hospitalization for Rehabilitation. Benefits are provided for an admission or transfer to a CareFirst BlueChoice approved facility for rehabilitation. Benefits provided during any confinement will not exceed the benefit limitation, if any, stated in the Schedule of Benefits. As used in this paragraph, a confinement means a continuous period of hospitalization or two or more admissions separated by 30 days. This limit on hospitalization applies to any portion of an admission that:
1. Is required primarily for Physical Therapy or other rehabilitative care; and
2. Would not be Medically Necessary based solely on the Member's need for inpatient acute care services other than for rehabilitation.
